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A New Tool in Rectal Cancer Surgery: Can Fluorescence Help Prevent Leaks?

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A New Tool in Rectal Cancer Surgery - Can Fluorescence Help Prevent Leaks

When patients have surgery for rectal cancer, the surgeon often removes the tumor and then reconnects the bowel. This connection is called an anastomosis. One of the biggest risks after this surgery is an anastomotic leak. This happens when the new join does not heal properly and starts to leak. Leaks can cause infections, longer hospital stays, and sometimes more surgery.

Doctors have been looking for ways to reduce this risk. One new method uses a dye called indocyanine green (ICG). During surgery, the surgeon gives a small injection of ICG. With a special camera, they can see how well blood is flowing to the bowel. Good blood flow is important for healing. If the blood flow looks poor, the surgeon can change where they reconnect the bowel.

A large study tested this method in 766 patients with rectal cancer across Europe. Half had surgery with the dye, and half had standard surgery without it. The results showed fewer leaks in the group where ICG was used: 10% compared with 15%. While this difference was not large enough to be called “statistically significant,” it suggests that using ICG may help reduce some types of leaks, especially the milder ones. Importantly, the dye was safe, with no harmful side effects.

For patients, this is encouraging news. It means surgeons may have another tool to make rectal cancer surgery safer. More research is needed to confirm these results and to find the best way to use ICG.

DOI: 10.1016/S2468-1253(25)00101-3

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